• Journal of Korean Neurosurgical Society
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• v.62 no.1
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• pp.46-52
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• 2019

Objective : The aim of this nationwide study was to analyze the current state of patients with newly diagnosed metastatic spine tumors according to surgical methods. Methods : Data was extracted from the Korean Health Insurance Review and Assessment Service database. Surgery was categorized into three methods : fusion, decompression, and vertebroplasty. Data included patient age, sex, health insurance type, and co-morbidities. Survival rates of metastatic spine tumor patients according to each surgical method were evaluated. Results : Among 1677 patients who had an operation, 823 patients were treated by fusion, 141 patients underwent decompression, and 713 patients were treated by vertebroplasty. The three most prevalent primary tumor sites were the lung, breast, and liver & biliary. On the other hand, the three most prevalent primary tumor sites of patients who underwent surgery were the lung, liver & biliary, and the prostate. The median survival periods for each surgical method in the metastatic spine tumor patients were 228 days for those who underwent surgery, 249 days for decompression, and 154 days for vertebroplasty. Age, sex, and comorbidities significantly affected survival rate. Conclusion : For every primary tumor site, decompression was the least common surgical method during the study period. Although the three surgical methods did not significantly affect the survival period, patients with a poor prognosis tended to undergo vertebroplasty.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.57-63
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• 2022

Objective : To study the factors relating to operative treatment for spinal metastasis in Thailand during 2005-2014 and to determine the hospital costs, mortality rate, and incidence of perioperative complication. Methods : Inpatient reimbursement data from 2005 to 2014 was reviewed from three national healthcare organizations, including the National Health Security Office, the Social Security Office, and the Comptroller General's Department. The search criteria were secondary malignant neoplasm of bone and bone marrow patients (International Classification of Diseases 10th revision, Thai modification codes [ICD 10-TM], C79.5 and C79.8) who underwent spinal surgical treatment (ICD 9th revision, clinical modification procedure with extension codes [ICD 9-CM], 03.0, 03.4, 03.09, and 81.0) during 2005-2014. Epidemiology, comorbidity, and perioperative complication were analyzed. Results : During the study period, the number of spinal metastasis patients who underwent operative treatment was significantly increased from 0.30 to 0.59 per 100000 (p<0.001). More males (56.14%) underwent surgical treatment for spinal metastasis than females. The most common age group was 45-64 (55.1%). The most common primary tumor sites were the unknown origin, lung, breast, prostate, and hepatocellular/bile duct. Interestingly, the proportion of hepatocellular/bile duct, breast, and lung cancer was significantly increased (p<0.001). The number of patients who had comorbidity or in-hospital complication significantly increased over time (p<0.01); however, the in-hospital mortality rate decreased. Conclusion : During the last decade, operative treatment for spinal metastasis increased in Thailand. The overall in-hospital complication rate increased; however, the in-hospital mortality rate decreased.

• Herbal Formula Science
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• v.31 no.4
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• pp.295-313
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• 2023

Objectives : While treatments for cancer are advancing, the development of effective treatments for cancer metastasis, the main cause of cancer patient death, remains insufficient. Recent studies on Dichroae Radix have revealed that its active ingredients have the potential to inhibit cancer metastasis. This study aimed to investigate the cancer metastasis inhibitory effect of Dichroae Radix using network pharmacological analysis. Methods : The active compounds of Dichroae Radix have been identified using Traditional Chinese Medicine System Pharmacology Database and Analysis Platform. The UniProt database was used to collect each of information of all target proteins associated with the active compounds. To find the bio-metabolic processes associated with each target, the DAVID6.8 Gene Functional classifier tool was used. Compound-Target and Target-Pathway networks were analyzed via Cytoscape 3.40. Results : In total, 25 active compounds and their 62 non-redundant targets were selected through the TCMSP database and analysis platform. The target genes underwent gene ontology and pathway enrichment analysis. The gene list applied to the gene ontology analysis revealed associations with various biological processes, including signal transduction, chemical synaptic transmission, G-protein-coupled receptor signaling pathways, response to xenobiotic stimulus, and response to drugs, among others. A total of eleven genes, including HSP90AB1, CALM1, F2, AR, PAKACA, PTGS2, NOS2, RXRA, ESR1, ESR2, and NCOA1, were found to be associated with biological pathways related to cancer metastasis. Furthermore, nineteen of the active compounds from Dichroae Radix were confirmed to interact with these genes. Conclusions : The results provide valuable insights into the mechanism of action and molecular targets of Dichroae Radix. Notably, Berberine, the main active ingredient of Dichroae Radix, plays a significant role in degrading AR proteins in advanced prostate cancer. Further studies and validations can provide crucial data to advance cancer metastasis prevention and treatment strategies.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.687-692
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• 2022

Male breast cancer is rare, accounting for approximately 1% of breast cancers. Metastasis from extra-mammary malignancy to the breast in men is extremely rare. The most common primary tumors that metastasize to the breast in male are prostate, lung, stomach, colorectal cancer, melanoma, and sarcoma. To our knowledge, only a few cases of bladder cancer presenting with metastasis to the male breast have been reported, and metastasis with infiltration rather than mass is extremely rare. We report imaging findings on mammography and ultrasonography in a 59-year-old male with bladder cancer metastatic to the breast.

• Korean Journal of Radiology
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• v.22 no.6
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• pp.922-930
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• 2021

Objective: It is uncertain why a b-value range of 1500-2000 s/mm² is optimal. This study was aimed at qualitatively and quantitatively analyzing the optimal b-value range of synthetic diffusion-weighted imaging (sDWI) for evaluating prostatic index lesions. Materials and Methods: This retrospective study included 92 patients who underwent DWI and targeted biopsy for magnetic resonance imaging (MRI)-suggested index lesions. We generated sDWI at a b-value range of 1000-3000 s/mm² using dedicated software and true DWI data at b-values of 0, 100, and 1000 s/mm². We hypothesized that lesion conspicuity would be best when the background (i.e., MRI-suggested benign prostatic [bP] and periprostatic [pP] regions) signal intensity (SI) is suppressed and becomes homogeneous. To prove this hypothesis, we performed both qualitative and quantitative analyses. For qualitative analysis, two independent readers analyzed the b-value showing the best visual conspicuity of an MRI-suggested index lesion. For quantitative analysis, the readers assessed the b-value showing the same bP and pP region SI. The 95% confidence interval (CI) or interquartile range of qualitatively and quantitatively selected optimal b-values was assessed, and the mean difference between qualitatively and quantitatively selected b-values was investigated. Results: The 95% CIs of optimal b-values from qualitative and quantitative analyses were 1761-1805 s/mm² and 1640-1771 s/mm² (median, 1790 s/mm² vs. 1705 s/mm²; p = 0.003) for reader 1, and 1835-1895 s/mm² and 1705-1841 s/mm² (median, 1872 s/mm² vs. 1763 s/mm²; p = 0.022) for reader 2, respectively. Interquartile ranges of qualitatively and quantitatively selected optimal b-values were 1735-1873 s/mm² and 1573-1867 s/mm² for reader 1, and 1775-1945 s/mm² and 1591-1955 s/mm² for reader 2, respectively. Bland-Altman plots consistently demonstrated a mean difference of less than 100 s/mm² between qualitatively and quantitatively selected optimal b-values. Conclusion: b-value range showing a homogeneous background signal may be optimal for evaluating prostatic index lesions on sDWI. Our qualitative and quantitative data consistently recommend b-values of 1500-2000 s/mm².

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.384-390
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• 1994

Authors retrospectively compared the 99mTc MDP bone scans and corresponding MR imagings in 20 patients with histologically proven malignancy, Mean interval of the two studies was 16.6 days, Cancer diagnosis Included 8 lung, 2 each of colon, breast, stomach, 1 each of prostate, thyroid, malignant lymphoma and 3 adenocarcinoma of unknown primary site. Of the 105 regions compared, :t6 regions were positive for metastases in bone scans or MR imagings. 30 regions(65.2%) were positive by bone scan and 44 regions(95.7%) by MR imaging. 87 regions(82.9%) were concordantly positive or negative by bone scan and MR imaging, but 18 regions(17.1%) were discordant. In the discordant regions, 16 regions positive in MR imaging were negative in bone scan. The greatest number of discordant findings occured in the cervical region and in the patient with stomach cancer. Our results suggest that the sensitivity of MR Imaging is greater than that of bone scan in detecting spinal metastases. And bone scan is useful screening test of metastasis for evaluating entire skeleton including spine.